Individual provider Active NPI

Stephen H. Ducatman, M.D.

  • Dermatology Physician
  • Naples, FL
National Provider Identifier
1487605242
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME90153 Issued in FL
Practice address
2235 Venetian CT
Suite 1
Naples, FL 34109-8728
Phone
(239) 596-9337
Fax
(239) 596-9466
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X FLME0090153 FL
Dermatology Physician 207N00000X ME90153 FL Primary

Addresses

Primary practice location

2235 Venetian CT
Suite 1
Naples, FL 34109-8728

Mailing address

2235 Venetian CT
Suite 1
Naples, FL 34109-8728
Phone (239) 596-9337

Other identifiers 1

IdentifierTypeStateIssuer
269468900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
FLME0090153FLMDDermatology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1487605242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 VENETIAN CT",
            "address_2": "SUITE 1",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341098728",
            "telephone_number": "239-596-9337",
            "fax_number": "239-596-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 VENETIAN CT",
            "address_2": "SUITE 1",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341098728",
            "telephone_number": "239-596-9337",
            "fax_number": "239-596-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCATMAN",
        "first_name": "STEPHEN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "FLME0090153",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME90153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269468900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.